Admixture analysis of age at onset in obsessive–compulsive disorder

2005 ◽  
Vol 35 (2) ◽  
pp. 237-243 ◽  
Author(s):  
RICHARD DELORME ◽  
JEAN-LOUIS GOLMARD ◽  
NADIA CHABANE ◽  
BRUNO MILLET ◽  
MARIE-ODILE KREBS ◽  
...  

Background. Age at onset (AAO) has been useful to explore the clinical, neurobiological and genetic heterogeneity of obsessive–compulsive disorder (OCD). However, none of the various thresholds of AAO used in previous studies have been validated, and it remains an unproven notion that AAO is a marker for different subtypes of OCD. If AAO is a clinical indicator of different biological subtypes, then subgroups based on distinct AAOs should have separate normal distributions as well as different clinical characteristics.Method. Admixture analysis was used to determine the best-fitting model for the observed AAO of 161 OCD patients.Results. The observed distribution of AAO in OCD is a mixture of two Gaussian distributions with mean ages of 11·1±4·1 and 23·5±11·1 years. The first distribution, defined by early-onset OCD, had increased frequency of Tourette's syndrome and increased family history of OCD. The second distribution, defined by late-onset OCD, showed elevated prevalence of general anxiety disorder and major depressive disorder.Conclusions. These results, based on a statistically validated AAO cut-off and those of previous studies on AAO in OCD, suggest that AAO is a crucial phenotypic characteristic in understanding the genetic basis of this disorder.

CNS Spectrums ◽  
2009 ◽  
Vol 14 (7) ◽  
pp. 362-370 ◽  
Author(s):  
Maria Alice de Mathis ◽  
Juliana B. Diniz ◽  
Roseli G. Shavitt ◽  
Albina R. Torres ◽  
Ygor A. Ferrão ◽  
...  

ABSTRACTIntroduction: Research suggests that obsessive-compulsive disorder (OCD) is not a unitary entity, but rather a highly heterogeneous condition, with complex and variable clinical manifestations.Objective: The aims of this study were to compare clinical and demographic characteristics of OCD patients with early and late age of onset of obsessive-compulsive symptoms (OCS); and to compare the same features in early onset OCD with and without tics. The independent impact of age at onset and presence of tics on comorbidity patterns was investigated.Methods: Three hundred and thirty consecutive outpatients meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for OCD were evaluated: 160 patients belonged to the “early onset” group (EOG): before 11 years of age, 75 patients hadResults: The EOG had a predominance of males, higher frequency of family history of OCS, higher mean scores on the “aggression/violence” and “miscellaneous” dimensions, and higher mean global DY-BOCS scores. Patients with EOG without tic disorders presented higher mean global DY-BOCS scores and higher mean scores in the “contamination/cleaning” dimension.Conclusion: The current results disentangle some of the clinical overlap between early onset OCD with and without tics.


1991 ◽  
Vol 158 (2) ◽  
pp. 260-263 ◽  
Author(s):  
Homa F. Noshirvani ◽  
Yiannis Kasvikis ◽  
Isaac M. Marks ◽  
Fivos Tsakiris ◽  
William O. Monteiro

Among 307 adults with OCD, early onset (age 5–15 years) was more common in men and later onset (age 26–35 years) in women. Early onset was associated with more checking, and late onset with more washing. More women than men had a history of treated depression; 12% of the women but none of the men had a history of anorexia. More women than men were married. Gender-divergent features may reflect differential aetiological factors. Our sample resembled others in the literature in its slight overall female preponderance, low rate of marriage and low fertility, onset mainly before age 35 years, chronicity, and common present and past depression.


1999 ◽  
Vol 14 (8) ◽  
pp. 434-441 ◽  
Author(s):  
F. Bogetto ◽  
S. Venturello ◽  
U. Albert ◽  
G. Maina ◽  
L. Ravizza

SummaryThe purpose of the present study was to investigate the gender-related differences of clinical features in a sample of obsessive-compulsive (OCD) patients. One hundred and sixty outpatients with a principal diagnosis of obsessive-compulsive disorder (DSM-IV, Y-BOCS = 16) were admitted. Patients were evaluated with a semi-structured interview covering the following areas: socio-demographic data, Axis I diagnoses (DSM-IV), OCD clinical features (age at onset of OC symptoms and disorder, type of onset, life events and type of course). For statistical analysis the sample was subdivided in two groups according to gender. We found an earlier age at onset of OC symptoms and disorder in males; an insidious onset and a chronic course of illness were also observed in that group of patients. Females more frequently showed an acute onset of OCD and an episodic course of illness; they also reported more frequently a stressful event in the year preceding OCD onset. A history of anxiety disorders with onset preceding OCD and hypomanic episodes occurring after OCD onset was significantly more common among males, while females showed more frequently a history of eating disorders. We found three gender-related features of OCD: males show an earlier age at onset with a lower impact of precipitant events in triggering the disorder; OCD seems to occur in a relative high proportion of males who already have phobias and/or tic disorders; and a surfeit of chronic course of the illness in males in comparison with females.


CNS Spectrums ◽  
2000 ◽  
Vol 5 (S4) ◽  
pp. 40-46 ◽  
Author(s):  
Donald W. Black

AbstractThis manuscript summarizes presentations by an international panel of experts, representing Brazil, Israel, Italy, Mexico, Portugal, Spain, and the United States, at a symposium on obsessive-compulsive disorder (OCD) and its possible subtypes. Presentations concerned both OCD proper, as well as putative obsessive-compulsive-spectrum disorders (autistic disorders, eating disorders, pathological gambling, and schizo-obsessive disorder). Projects discussed included a study assessing impulsive temperament in eating disorder patients, a study on serotonin receptor sensitivity in autism, a study of sleep EEG abnormalities in OCD, a study of dissociation in pathological gamblers, papers on aspects of schizo-obsessive patients, a study addressing biological alterations in OCD, data from a new family study on OCD, data from a molecular genetic study of OCD, a factor analytic study of Tourette disorder, a study hypothesizing the existence of an OCD continuum, and, finally, a paper on early- vs late-onset OCD. General discussion followed leading to a consensus that 1) OCD is likely heterogeneous with multiple subtypes; 2) division of patients by age-at-onset probably represents a robust and valid subtyping scheme; 3) the presence of schizophrenic features probably identifies a valid subtype; 4) the validation of subtypes in the future will be informed by both family-genetic studies, as well as studies of biological alterations in OCD; and 5) the study of obsessive-compulsive spectrum disorders adds to our understanding of the OCD phenomenon, and helps in our search to identify valid subtypes.


2013 ◽  
Vol 16 (9) ◽  
pp. 1951-1958 ◽  
Author(s):  
Leonhard Lennertz ◽  
Petra E. Franke ◽  
Hans Jörgen Grabe ◽  
Friederike Rampacher ◽  
Svenja Schulze-Rauschenbach ◽  
...  

Abstract Neuropeptide S (NPS) is a novel central acting neuropeptide that modulates several brain functions. NPS has shown strong anxiolytic-like effects and interactions with other central transmitter systems, including serotonin and glutamate. A coding variation (Asn107Ile) of the NPS receptor gene (NPSR1) was associated with panic disorder and schizophrenia. Based on these encouraging findings, the present study aimed at exploring a potential role of NPSR1 in obsessive–compulsive disorder (OCD). A sample of 232 OCD patients was successfully genotyped for the NPSR1 Asn107Ile variant (rs324981). Age at onset was taken into account to address the heterogeneity of the OCD phenotype. The NPSR1 genotype significantly affected age at onset of the OCD patients, with a mean age at onset approximately 4 yr earlier in homozygous carriers of the low-functioning Asn107 variant compared to patients with at least one Ile107 variant (p = 0.032). Case–control analyses with 308 healthy control subjects reveal a highly significant association of the Asn107 variant with early onset OCD (odds ratio = 2.36, p = 0.0004) while late onset OCD or the OCD group as a whole were unrelated to the NPSR1 genotype. Based on our association finding relating NPSR1 genotype to early onset OCD, we suggest a differential role of the NPS system in OCD. In particular, the early onset OCD subtype seems to be characterized by a genetically driven low NPS tone, which might affect other OCD-related transmitter systems, including the serotonin and glutamate systems. In agreement with preclinical research, we suggest that NPS may be a promising pharmacological candidate with anti-obsessional properties.


2013 ◽  
Vol 44 (1) ◽  
pp. 185-194 ◽  
Author(s):  
G. E. Anholt ◽  
I. M. Aderka ◽  
A. J. L. M. van Balkom ◽  
J. H. Smit ◽  
K. Schruers ◽  
...  

BackgroundResearch into age of onset in obsessive–compulsive disorder (OCD) has indicated significant differences between patients with early and late onset of the disorder. However, multiple criteria have been used arbitrarily for differentiating between early- and late-onset OCD, rendering inconsistent results that are difficult to interpret.MethodIn the current study, admixture analysis was conducted in a sample of 377 OC patients to determine the number of underlying populations of age of onset and associated demographic and clinical characteristics. Various measures of anxiety, depression, co-morbidity, autism, OCD, tics and attention deficit hyperactivity disorder (ADHD) symptoms were administered.ResultsA bimodal age of onset was established and the best-fitting cut-off score between early and late age of onset was 20 years (early age of onset ⩽19 years). Patients with early age of onset were more likely to be single. Early age of onset patients demonstrated higher levels of OCD severity and increased symptoms on all OCD dimensions along with increased ADHD symptoms and higher rates of bipolar disorder.ConclusionsIt is suggested that 20 years is the recommended cut-off age for the determination of early versus late age of onset in OCD. Early age of onset is associated with a generally graver OCD clinical picture and increased ADHD symptoms and bipolar disorder rates, which may be related to greater functional implications of the disorder. We propose that age of onset could be an important marker for the subtyping of OCD.


2005 ◽  
Vol 17 (2) ◽  
pp. 208-213 ◽  
Author(s):  
Robert M. Roth ◽  
Denise Milovan ◽  
Jacinthe Baribeau ◽  
Kieron O’Connor

PEDIATRICS ◽  
1991 ◽  
Vol 88 (5) ◽  
pp. 992-992
Author(s):  
Gregory L. Hanna ◽  
James T. MCCracken ◽  
Dennis P. Cantwell

Basal prolactin concentrations were measured before treatment in 18 children and adolescents with obsessive-compulsive disorder as well as in 15 of these patients after 4 and 8 weeks of clomipramine treatment. Basal prolactin levels were influenced by a history of chronic tic disorder and by the duration and severity of obsessive-compulsive symptoms. Clomipramine administration significantly increased basal prolactin levels. A slight decline in prolactin levels during the last 4 weeks of clomipramine treatment was positively correlated with a favorable treatment response and negatively correlated with duration of illness. If the changes in prolactin levels observed during clomipramine treatment are due primarily to changes in serotonergic neurotransmission, these data suggest that clomipramine treatment of obsessive-compulsive disorder produces an adaptive decrease in the responsiveness of serotonergic receptors.


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